Patricia Wexler is a well-known dermatologist with a regular column in Allure magazine. She has a successful New York practice where she offers liposuction, facial fat transplants, Botox, laser resurfacing, dermal injections, and chemical peels, among other procedures. She is also an associate clinical professor at the Mount Sinai School of Medicine. Now, along with a host of other dermatologists, Wexler has joined the retail antiwrinkle/anti-aging part of the skin-care business, and why not? The financial potential is astronomical.

As always, when we begin reviewing a product line, we call the company and ask them to send any research, documentation, or any other proof that the claims being asserted are true. We also ask for ingredient lists, which are mandated by the FDA and not confidential in the least, so it's not as if we're asking for proprietary or classified details about their products. After some back-and-forth telephone calls and emails, we finally received a call from Liz Freeman of Tractenberg Advertising, the public relations firm that represents Patricia Wexler M.D. Skin Care products. She explained to us that due to the "negative reviews" we've written about other product lines, she would not be sending me any information unless we would guarantee a positive review. We explained we couldn't promise anything other than to do an honest assessment of the products, and, hence, they sent nothing—no information at all. This is what happens with most of the companies we call to ask for research and ingredient statements; because we can't and won't promise the same glowing reviews handed out carte blanche by fashion magazines, we end up being ignored. Clearly, this is another company that isn't confident or convinced that their work can withstand objective scrutiny. And as we reviewed their products it became obvious why: they have more shortcomings than strengths, and they couldn't possibly have the solid clinical data to back up their claims.

Wexler bases her line on the concept that her products can inhibit the activity of matrix metalloproteinases (MMP). According to Wexler, "Until now, only expensive in-office procedures were able to inhibit MMP skin-degrading action.…" Well, without a doubt, inhibiting MMPs is good for skin, but the notion that only Wexler's products or expensive medical procedures can provide that benefit is not substantiated by the research, and we mean by more than just a little research.

There are 23 different types of MMPs, each representing a type of enzyme that causes substances in skin to break down. Of the 23 types, MMP-1, also known as collagenase, is responsible for the destruction of collagen. Generated primarily by unprotected sun exposure and the aging process, MMP-1 is also present in sebum (which may be a cause of acne). In general, it is safe to say that MMPs are a problem for skin (Sources: Contact Dermatitis, August 2007, pages 100–104; Journal of Investigative Dermatology, October 2005, pages 673–684; Photochemistry and Photobiology, October 2003, pages 355–360; and Photodermatology, Photoimmunology, and Photomedicine, April 2001, pages 178–183).

One of the best ways to decrease or prevent the formation of MMPs in skin, particularly MMP-1, is by following smart sun-protection routines, including application of well-formulated sunscreen, a recommendation that is not unique to this product line. There is also research showing that other compounds can also inhibit formation of MMPs, such as epigallocatechin-3-gallate (a derivative of green tea), retinoic acid (RA), eicosapentaenoic acid (omega-3 fatty acid), beta-carotene, DHEA (though this is controversial), polysaccharides, vitamins E and C, and flavonoids, to name a few. These compounds also are known to increase the formation of other substances in tissue (called TIMP, which stands for tissue inhibitors of metalloproteinases) that act as inhibitors of metalloproteinases, so that when these increase in skin, MMPs decrease (Sources: Journal of Investigative Dermatology, February 2005, pages 315–323; Journal of Lipid Research, August 2005, pages 1712–1720; Journal of Dermatologic Science, December 2005, pages 195–204; American Journal of Pathology, July 2004, pages 167–174; Free Radical Biology and Medicine, September 2004, pages 654–670; Biomedicine and Pharmacotherapy, July-August 2003, pages 187–194; and Photochemical and Photobiological Sciences, October 2002, pages 826–833). Interestingly enough, these compounds are not the showcased MMP-inhibiting ingredients in Wexler's products.

What many of Wexler's products do contain in the way of fending off MMPs are ingredients such as Pyrus malus (apple) fruit extract. We couldn't find any research showing that apple fruit extract was of benefit for skin, but catechin and epicatechin have been extracted from the seeds of this type of apple, and there is some research showing that these extracts can inhibit MMPs. Several products also contain Cinnamomum cassia bark extract, which has been shown, in limited research, to inhibit MMPs. Soybean extract is another staple in this product line, and there is definitely research showing that the polyphenol and isoflavone it contains can have benefit for skin as an antioxidant; what is less clear is information about its role in reducing MMPs when it is in its whole form. We do know that reducing free-radical damage is one major way to stop collagen destruction, so it isn't a great leap to assume this benefit as well. However, this ingredient is not unique to Wexler's line, and is used frequently in other skin-care products, including many from the inexpensive Aveeno line (Sources: International Journal of Molecular Medicine, October 2005, pages 677–681; Journal of Ethnopharmacology, February 2005, pages 101–106; Pharmacological Research, September 2004, pages 279–285; International Journal of Cosmetic Science, February 2005, page 17; British Journal of Dermatology, October 2003, page 681; Archives of Dermatological Research, July 2003, pages 112–116; and Plant Cell Reports, February 2001, pages 169–174).

Wexler asserts that her products contain "the most potent inhibitors of MMP activity available on the market" and she quotes clinical and laboratory studies that supposedly prove her products are more effective than others. Meanwhile, as we mentioned, the studies were not made available to us, so there is no way to know how she arrived at those conclusions. We just have to take her word for it. For our part, we’d rather see the studies.

Technical assertions aside, these products do have some excellent qualities, but the selling point that they are the most effective skin-care products just short of a trip to Wexler's office is hyperbole to the max. There are assuredly some interesting advanced formulations in this group, but there also are some serious missteps. Many of the products come in jar packaging, which as we know won't keep the important ingredients stable during use. Surprisingly, her products also contain fragrance and coloring agents, which dermatologists know (or at least should know) can be problematic for skin, as well as being completely unnecessary in a skin-care product. From a practical standpoint, these are not inexpensive products, but the price isn't out of the ballpark either. Bath and Body Works is selling Patricia Wexler M.D. Skin Care at most of their stores across the country.